EMS One-Stop

Recorded on the floor of the EMS|MC EMSpire Conference in Charleston, South Carolina, this episode of EMS One-Stop finds host Rob Lawrence in conversation with long-time collaborator and EMS advocate Matt Zavadsky. Fresh off the longest federal government shutdown in history, Rob and Matt unpack what the hyper-turbulence in Washington really means for EMS: suspended Medicare extenders, disrupted grant programs, agencies taking out loans just to meet payroll and training programs put on hold. They break down NAEMT’s flash poll on the shutdown’s impact, the promise of the Treatment in Place (TIP) legislation, and why associations “hunting as a pack” on Capitol Hill matters more than ever. Along the way, they spotlight EMSIntel.org as a national barometer of EMS funding, staffing and response time crises, and issue a clear call to action for providers, billers and leaders to use association tools to contact their members of Congress. | MORE: Government reopens: What EMS providers need to know right now In the second half, Rob is joined by Dr. Shannon Gollnick, paramedic, EMS leader and organizational psychologist, to explore how artificial intelligence is reshaping EMS — right now. Shannon makes the case that AI is “not the future; it is the present,” and that agency leaders must urgently build literacy, policies and guardrails around its use. They dig into the difference between HIPAA-compliant, embedded AI in ePCR systems, and risky open tools like ChatGPT, touching on hallucinations, embedded code and emerging Medicare fraud-detection programs. | MORE: Artificial to augmented intelligence. How Dr. Shannon Gollnick wants EMS to work smarter, not harder Rob and Shannon talk about AI as a powerful but potentially dangerous tool — “like having a tiger” — and outline practical steps for chiefs: Ask: “Do we have an AI policy?” Define what AI can and cannot be used for Insist that every AI-generated work product is double-checked by a human before it hits the record Memorable quotes “We weren't here to actually scare you off it. We're here to let you know that it's here, but it's like having a tiger, right? We all love to have a tiger, but it has to be contained in some sort of guard, otherwise it's going to run rife and cause havoc, and we don't want that.” — Rob Lawrence “This is part of the hyper-turbulence that's occurring in EMS right now.” — Matt Zavadsky “So I think the message for the profession right now is, now is not the time to put your foot on the brake. It's time to put your foot on the gas.” — Matt Zavadsky “We put the fun into function.” — Dr. Shannon Gollnick “I think it's important to understand that AI is not the future. It is the present. We are currently here right now. And it's nothing to be afraid of.” — Dr. Shannon Gollnick “If you're not doing it, I promise you that your staff is doing it and they're playing around with AI.” — Dr. Shannon Gollnick “Guardrails don't exist from a congressional standpoint. They don't exist from a regulatory standpoint. The technology is moving far too fast. So we as agency leaders have to take the lead in putting up some of those guardrails.” — Dr. Shannon Gollnick “There are ePCR software out there that are using proprietary AI that will use AI-generated narratives. And that absolutely is 100% good to go. What we don't want to see is our crews putting in their ChatGPT to have ChatGPT write their narrative.” — Dr. Shannon Gollnick “ChatGPT has embedded code inside of it that you can't see, but that code is there ... so what we're kind of afraid to do is to say, hey, what happens 6 months from now, 8 months from now when Medicare does an audit, they run your ePCRs and find all of this embedded code from ChatGPT ... you open yourself up for a lot of compliance issues.” — Dr. Shannon Gollnick Additional resources: EMS Intel EMS News Tracker American Ambulance Association Advocacy NAEMT Advocacy EMS shutdown survival: What leaders need to know now Charting the future: How AI is rewriting the EMS narrative Episode timeline: 00:21 – Rob introduces guest Matt Zavadsky 02:02 – Rob recaps the 40-plus-day federal government shutdown, questions about reopening, and his upcoming return to Capitol Hill for renewed advocacy 02:02 – Matt frames the shutdown as part of the “hyper turbulence” in EMS; explains the regulatory suspensions, pauses in Medicare extenders and grants, and how cash-flow uncertainty forced some agencies to take out loans just to make payroll 03:04 – Matt details NAEMT’s flash poll (408 agency responses) showing suspended training and grant-funded programs, and warns of a possible repeat shutdown around January 30 03:54 – Rob and Matt discuss the reopening of government, ongoing bipartisan work, and the risk that everything “comes to a grinding halt” again if Congress can’t agree 04:51 – Matt explains why NAEMT released the shutdown-impact poll even as government reopened and stresses the need to keep pushing for permanent relief from Medicare extenders and advancement of key bills like Treatment in Place (TIP) 06:03 – Matt outlines the House and Senate TIP companion bills and why Medicare paying for treatment in place is better for patients, EMS, the health system and the Medicare trust fund 06:54 – Rob notes broad association/provider support and professional lobbyists on the Hill; Matt stresses that field providers, administrators and billers must still use association legislative portals to send letters to Congress 08:08 – Matt describes a surge in communities reevaluating their EMS delivery models because of staffing, finance and subsidy challenges — “a great time to be an EMS consultant” 09:09 – Rob introduces EMSIntel.org as a curated clearinghouse of EMS news, used to show communities they aren’t alone; describes failed tax measures and funding referenda 10:15 – Matt cites EMS Intel data: ~85% of stories each month involve funding, staffing or response times; Rob and Matt stress the ubiquity of these themes from big cities to small towns 11:09 – Rob highlights mutual aid tensions and taxpayers questioning why they “pay to send our resources somewhere else;” both emphasize that hyper-turbulence and funding gaps are national issues 13:23 – Rob resets the scene from the EMSpire conference and recaps Matt’s Hill update before introducing Dr. Shannon Gollnick 14:41 – Shannon gives his backstory: in EMS since 1996, paramedic since 2002, progression into EMS leadership, doctorate in organizational psychology and focus on how organizations function 15:14 – “We put the fun into function.” 15:24 – Rob invites Shannon to talk AI, calling it “the specter we are embracing everywhere,” and references HIPAA concerns; Shannon opens with the core message: AI is not the future, it’s the present, and nothing to be afraid of 16:03 – Shannon urges leaders to build AI literacy, noting that if agencies aren’t using it, their staff and the younger generation already are 16:28 – Shannon emphasizes policy and procedure: AI guardrails aren’t coming from Congress or regulators, so agency leaders must define how AI will be used and where its limits are 16:55 – Rob reminds listeners that AI in EMS isn’t new, citing early monitor rhythm interpretation in the UK; Shannon underscores that crews already use AI tools and that unmanaged cut-and-paste practices can create billing and compliance risks 17:24 – Shannon explains the dangers of using open tools like ChatGPT for ePCR narratives: potential PHI exposure in a “black box” system and AI hallucinations generating plausible but false patient information 18:21 – Shannon describes how AI “wants to answer your question and make you happy,” leading to made-up details, and shares examples from testing minimal-input scenarios that returned overly detailed, inaccurate narratives. 19:03 – Shannon calls ChatGPT “kind of a snitch,” explaining embedded code markers that fraud detection tools — and increasingly Medicare’s AI-based “Wiser” program — can use to identify AI-written content in documentation 19:59 – Shannon warns about retrospective audits and compliance exposure if ChatGPT-coded narratives are found in ePCRs, noting that AI rules are still emerging and tech is outrunning regulation 20:51 – Rob summarizes the mixed message: AI is here and being built into devices and software, but there are real dangers. They discuss data going “to the cloud” — which Shannon defines as “somebody else’s computer.” 21:24 – Shannon frames AI as a powerful tool that can “put a lot of holes in the wall” if misused; he references fraudulent AI uses and deepfakes as emerging issues 22:05 – Shannon compares AI’s impact to the internet’s paradigm shift; Rob gives a “spoiler alert” about his own workflow using transcripts and ChatGPT agents, and notes the importance of reading and checking any AI-generated output 22:45 – Shannon reinforces that AI makes mistakes and cannot understand human context; he uses his “How you doing?” Joey Tribbiani vs. Tony Soprano example to illustrate contextual nuance 23:06 – Rob expands the context point with the “Friends”/“Sopranos” slide and reminds listeners that once AI-written words are published, “you said it.” Shannon highlights the WebMD effect and AI-driven self-diagnosis risks. 24:02 – They note that ChatGPT can generate long, complex diagnoses without sufficient patient context, leading to errant or misleading outcomes if misused clinically 25:00 – Rob summarizes: AI is here and, used correctly, is a good thing; advises chiefs to ask their teams, “Do we have an AI policy?” 25:27 – Shannon outlines what an AI policy should contain: acknowledgment that AI is here; clear, non-fearful framing; specificity on what decisions AI can support; and clarity on which tools (e.g., embedded EPCR AI) are allowed versus prohibited uses of ChatGPT 26:17 – Shannon stresses AI should not be used for clinical decision-making or clinical narrative writing; its role should be administrative only,

In this episode of the EMS One-Stop podcast, host Rob Lawrence welcomes Dr. Hezedean Smith, who spotlights the human and operational toll of Hurricane Melissa on Jamaica and the wider Caribbean. Dr. Smith draws from first-hand perspective from the ground, detailing catastrophic damage to homes, utilities, roads and communications — which compounded the workload and emotional burden for Jamaica Fire Brigade (JFB) firefighters and EMS providers. Dr. Smith highlighted the Brigade’s Amazon Wish List effort, which aims to route essential personal items and operational supplies directly to affected JFB members and stations to sustain continuity of operations and support responders’ families. After the break, Dr. Smith switched hats as the newly elected President of NEMSMA to outline the association’s renewed momentum: New association management support Expanded member services and credentials The inaugural NEMSMA Leadership Conference The NEMSMA Leadership Conference will take place in Washington, D.C., March 23-24, 2026, intentionally adjacent to EMS on the Hill to create a leadership-plus-advocacy “two-fer.” Highlights include keynote Gen. Robert Neller (Ret.), plus a deep bench of EMS leaders and educators. Memorable quotes from Dr. Hezedean Smith “Many homes destroyed, utility systems interrupted, critical infrastructure in terms of communities having the ability to communicate, leaving thousands displaced, even fire stations having operational challenges as it relates to communication and interoperability ... ” “I stayed in the local fire station. I wanted to be there with the men and women on the ground, to make sure that I had that communication, that constant contact with them.” “My focus will be on the firefighters and ensuring that we get enough supplies to go directly to the firefighters.” “We want to tear down silos. We want to redefine leadership and ensure that we continue to collaborate across this globe.” Additional resources: Jamaica Fire Brigade – Amazon Wish List National EMS Management Association (NEMSMA) NEMSMA Leadership Conference: Washington, D.C., March 23-24, 2026 EMS on the Hill, March 25-26, 2026, Arlington, Virginia International Journal of Paramedicine EMS One-Stop: General Robert Neller on ethical leadership and adaptability Episode timeline: 00:46 – Quick industry/policy update 01:27 – Set-up: Hurricane Melissa overview; impact stats and current situation 02:12 – Welcome Dr. Hezedean Smith 02:26 – Dr. Smith’s backstory: Jamaica roots, USAF medic, Orlando FD, two fire chief roles, GES Consulting, Caribbean EMS focus 04:20 – First reactions to Melissa: scale of damage; compounded human toll 05:58 – Deployment cadence: aligning with JFB command, CDEMA, national EOC; travel hurdles; rapid integration on arrival 08:28 – Why existing relationships matter; staying in-station with crews; supporting leaders and frontline needs 11:13 – Call to action: Amazon wish list for responders’ personal and operational needs; distribution via JFB logistics 13:20 – Specific needs (PPE, boots, clothing, hygiene, basic medical supplies) and the ongoing recovery realities 17:46 – NEMSMA — new president, renewed energy, new AMC, who NEMSMA serves 20:14 – Board/leadership shout-outs; programs (FTEP, ACPE), member services, momentum 22:49 – Conference preview (Mar 23–24, 2026, D.C.): theme — disruptive leadership; Gen. Robert Neller keynote; speaker lineup; proximity to EMS on the Hill 26:29 – IJOP collaboration and research-to-podcast pipeline; communications and sponsorship improvements 28:29 – Closing thanks; unified call to support JFB and engage with NEMSMA initiatives Rate and review the EMS One-Stop podcast Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback. Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.

From Medicare cuts to billing delays, Asbel Montes joins Rob Lawrence to share practical strategies EMS agencies can use to weather the reimbursement storm In this episode of the EMS One-Stop podcast, we tackle the fast-moving realities of a federal shutdown and what it means for EMS finance, reimbursement and day-to-day operations. Rob Lawrence sits down with Solutions Group’s Asbel Montes — a veteran of EMS reimbursement and policy expertise — to decode where Congress is (and isn’t), what CMS’s temporary claims hold really means, and how ambulance services can protect cash flow while preparing for potential reprocessing chaos if extenders aren’t promptly restored. Beyond the headlines, Montes lays out a pragmatic playbook: build a Plan B for cash continuity, align with your billing team on reprocessing workflows, and model exposure across payers tied to the Medicare fee schedule. The conversation then widens to balance billing — why federal change is unlikely soon and why state-level action is delivering practical protections — before closing with leadership lessons on adaptation, data and telling EMS’s story as a guide, not the hero. Memorable quotes from Asbel Montes “Our extender expired — that’s that additional payment that we get from Medicare of that 2%, 3%, 22.6% — it expired September the 30th, and it was tied to the House-approved CR that went over to the Senate.” “We’re solutions givers, as we say here at Solutions Group, not crisis managers. And if you have a plan, I can at least execute a plan.” “What turned out to be a smaller amount, now the cost associated with it, you started to really understand the complexities that really happened in people’s AR.” “If this lasts longer than 15 days … then I would basically have a plan in place. So I would be trying to find out from my billing team … what is your contingency plan to ensure I don’t see a hiccup in cash moving forward?” “The only way government can really invoke change is to make it hit where it hurts. And that’s what’s going on right now. They’re hitting the pocketbook and our industry is grappling with it right now.” Additional resources Asbel Montes: The government shutdown’s ripple effect on healthcare The Leadership Lab with Asbel Montes Episode timeline & key moments 00:21 – Why the shutdown matters to EMS reimbursement and operations 01:21 – Montes’s 101: role at Solutions Group; 28 years in EMS finance and policy 02:40 – Historical context: number and length of shutdowns; current Hill outlook 03:48 – The ambulance extenders expired (2% urban, 3% rural, 22.6% super-rural); CMS claims hold window 05:03 – Planning posture: realistic timelines; “we’re solutions givers, not crisis managers” 06:12 – Back-of-the-napkin math: short-term dollars vs. long-term reprocessing burden 07:43 – 2015–2016 déjà vu: retroactive fixes and the heavy lift for back-office AR 10:26 – Secondary impacts: VA eligibility, appeals, enrollments during a prolonged shutdown 11:11 – The “three-legged stool” for leaders: (1) have a plan with billing; (2) reconcile accounts & patient balances; (3) prevent cash-flow lag if more than15 days 14:06 – Framing the moment: “hurricane shutdown” response and recovery mindset 15:43 – Balance billing at the federal level: committee work, political pain and why movement is unlikely soon 18:19 – State action wins: consumer protections and access; examples of Medicare-indexed approaches 20:24 – Why ground ambulance stayed out of federal NSA; local regulation and state primacy 22:42 – “All politics are local”: using EMS’s public visibility to advocate for patients and providers 23:09 – Adaptation over preservation: seize the 6-18 month window; let data and clinicians lead reform 27:13 – Lawrence’s “Darwinism” takeaway: adaptation as survival 28:31 – The Leadership Lab podcast: purpose, cadence and upcoming guests; Montes’s leadership journey Rate and review the EMS One-Stop podcast Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback. Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.

In this episode of the EMS One-Stop podcast, our host, Rob Lawrence, sits down with Hollywood actor Rainn Wilson, who stars as Randy in “Code 3.” Known worldwide for his role as Dwight Schrute in The Office, Wilson has stepped into the world of EMS, portraying the life of a burned-out paramedic with both grit and humor. In the conversation, Wilson reflects on the process of bringing this story to life, his ride-along experiences in Los Angeles, and the powerful realities he uncovered about our profession. More than just a performance, Rainn has become an unexpected advocate for EMS. He speaks candidly about the underfunding of frontline providers, the emotional toll of the work and the sheer humanity that comes with being welcomed into people’s lives during their most vulnerable moments. Alongside the serious themes, he reminds us that Code 3 is also a comedy — one that captures the gallows humor, camaraderie and resilience medics carry with them on every shift. | MORE: Why ‘Code 3’ might be the most honest EMS film yet. From a ticking salary counter to fourth-wall confessions, this EMS road movie isn’t just another Hollywood take. It’s a love letter, a warning and a mirror. Memorable quotes from Rainn Wilson “Most of all, I just fell in love with the character of Randy.” “Bottom line, the fact that first responders are getting basically what people that work at Starbucks are getting paid really blew my mind.” “Well, one thing I never thought of, maybe stupidly so, is how vulnerable everything is because you're going into people's homes and they're in crisis.” “I think Rob, no one should be allowed to graduate from high school without their kind of basic CPR training.” “Everything about EMS — the tone, the vibe, the gallows humor, certainly all the technical medical elements, the burnout, the camaraderie, the idea that there's a mission here — they do it because they love it.” “Well, it was an honor to learn about this world and to make a movie that these workers are excited about and proud of.” “I want to say from the bottom of my heart, you know, ‘thank you. Thank you for your work. And, you know, I think it's grossly underappreciated, but, you know, America needs you.’” Episode timeline 00:26 – Rainn Wilson on the vulnerability of entering people’s homes in crisis 00:57 – “All we want to do is save your life. Some of you don’t make it easy.” 02:53 – Rainn’s first impressions of the “Code 3” script 03:38 – Falling in love with the character of Randy 04:22 – Discovering the realities of EMS work and shocking pay disparities 06:09 – Lessons from Wilson’s Los Angeles ride-along 10:12 – Wilson on CPR training and why everyone should learn it 12:29 – “We’re essentially a tube and a pump.” 13:11 – Rehearsals and the importance of portraying EMS medicine accurately 15:09 – On burnout, PTSD and the need to support medics’ mental health 18:08 – Using “Code 3” salary comparison as an advocacy tool 19:07 – Wilson praises Rob Riggle’s ED doctor role and its realism 20:41 – Cherishing the chance to shed light on EMS 21:10 – Reminder that the film is also a comedy — “a good old time with a bucket of popcorn” 22:25 – Final message: “America needs you. Keep saving lives.” Rate and review the EMS One-Stop podcast Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback. Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.

In this episode of the EMS One-Stop podcast, host Rob Lawrence sits down with Patrick Pianezza, co-writer of the new EMS film “Code 3”, a deeply honest and compelling portrayal of life on the ambulance. The film stars Rainn Wilson (“The Office”), Lil Rel Howery (“Free Guy”) and Aimee Carrero (“Elena of Avalor”), delivering a powerful performance that captures both the pressures and the humanity of EMS work. Using real-world experiences and stories from the field, “Code 3” highlights the passion, dedication and emotional toll experienced by EMS professionals every day. From burnout, to systemic challenges, the movie invites the public into the high-stakes world of emergency medical services, showing both the challenges and the heart behind the uniform. Patrick and Rob discuss not only the storytelling process, but also the personal experiences that informed the movie. Pianezza candidly shares the emotional toll of EMS work, the reality of burnout and the importance of mental health support for first responders. This episode is both a celebration of the dedication of those who serve in 911 and a call for awareness and gratitude for the vital work they perform. “Code 3” opens in selected cinemas on Sept. 12, 2025. Memorable quotes “I remember going to one of my old bosses and saying, ‘I think I'm burning out.’ The reaction I got was this dark chuckle … ‘We're all burnt out. Get back on the truck.’ That kind of festering mentality is not healthy.” — Patrick Pianezza “Six out of six people that I have worked with have unfortunately [died by] suicide, and the suicide rates for first responders is double that of the regular population … which is a statistic we need to fix.” — Patrick Pianezza “And it is … a good representation of life on the truck, on the street, with a guy who’s clearly burned out; but a person that cares, that has passion, commitment and will always do the right thing.” — Patrick Pianezza “There was no way to confront the story without talking about salaries, without talking about reimbursements … No one's gonna see a movie about Medicare, Medicaid, but we are as honest as we can be.” — Patrick Pianezza “This movie is nothing more than a gratitude tour for everyone who works in 911 … I’ll be a broken record here: thank you for what it is that you do because it matters. I’ve been in those boots and I’m here to tell you thank you.” — Patrick Pianezza “And as I say in my review, those who know me know my ability to take tactical naps during movies. Well, this one got two eyes open and absolutely five stars.” — Rob Lawrence Episode timeline 00:00 – Introduction: Rob Lawrence introduces Patrick Pianezza and the film “Code 3” starring Rainn Wilson 02:31 – Origins of “Code 3:” How the project started and the vision behind telling an authentic EMS story 05:01 – Creative team & casting: working with actors, crew and Rainn Wilson 08:01 – On-the-Street authenticity: translating real EMS experiences into the film 12:01 – Depicting burnout: emotional and mental challenges in EMS work 16:01 – Mental health & seeking help: Autobiographical elements and confronting burnout 20:01 – Systemic issues: salaries, Medicare, and Medicaid reimbursement challenges 24:01 – Impact on families & relationships: emotional toll beyond the job 27:01 – Personal reflection: Patrick’s journey, struggles and growth in EMS 29:01 – Gratitude tour: purpose of the film and acknowledging EMS professionals 32:01 – Closing thoughts: film release details, upcoming trailer and final messages of appreciation Enjoying the show? Send an email to editor@ems1.com to share feedback or suggest guests for upcoming episodes. 

This breaking-news edition of EMS One-Stop dives straight into the announcement that the National EMS Advisory Council (NEMSAC) has been dissolved. Host Rob Lawrence is joined by Dr. Brandon Morshedi (NEMSAC chair-elect) and Brenden Hayden (immediate past chair), who explain what NEMSAC is, what it achieved and why its sudden dismissal has left the EMS community frustrated, concerned and searching for answers. Together, they outline the role of NEMSAC as the sole statutory advisory body connecting EMS to the federal executive branch, describe the hundreds of volunteer hours that went into shaping advisories, and discuss what happens now that years of hard work and documents have been pulled from EMS.gov. This episode sets the record straight, provides a clear explainer of the process, and captures the disappointment — yet determination — of leaders committed to moving EMS forward despite this setback. Additional resources: How NEMSAC is composed — who sits on the council and what types of expertise are represented The NEMSAC’s statutory role advice/briefings at the federal level NEMSAC’s key accomplishments Episode timeline 01:08 – Rob introduces the breaking news: NEMSAC dissolved 02:22 – What is NEMSAC? Brenden explains its statutory role 04:52 – How does NEMSAC differ from associations? Direct advisory to the executive branch 06:42 – Appointments, terms and how continuity usually worked 08:44 – The depth of work: meetings, subcommittees, advisories, letters 11:23 – Examples of major advisories and public comment process 14:27 – Shock: key advisories removed from EMS.gov 19:13 – Explainer: FICEMS and how advisories flow through federal government 26:25 – How members felt when dismissal was announced 30:18 – What happens to unfinished advisories and research 34:20 – Associations’ role in keeping the work alive 35:50 – The advisory each guest is most proud of 39:41 – Lessons learned: influence, unified voice, process 43:25 – Final reflections: leadership, advocacy, and what comes next Enjoying the show? Email editor@ems1.com to share feedback or suggest guests for a future episode. 

In this episode of the EMS One-Stop podcast, host Rob Lawrence climbs back onto his soapbox to discuss two topics that directly impact on every EMS agency in America — the CAAS Ground Vehicle Standards (GVS) 4.0 and the simple, inexpensive steps we can take to stop ambulance theft. Joining Rob is longtime EMS leader and current CAAS GVS Administrator Mark Postma, who walks us through the origins of the standards, their national adoption and what’s new in the latest update. From ambulance remounting, to structural safety testing, Mark explains how GVS 4.0 has evolved to keep pace with manufacturing realities, supply chain delays and operational needs. The conversation then shifts to a shared passion for protecting fleet assets. Rob and Mark dissect the shockingly frequent problem of ambulance theft and how a $200 automatic immobilization device can prevent a $250,000 vehicle from disappearing — without relying on crews to remember to lock it. Additional resources: CAAS GVS V4.0 – Ground Vehicle Standard Commission on Accreditation of Ambulance Services (CAAS) – The New Standard in Mobile Healthcare Ambulance thefts in the U.S. surge: Over 40 stolen rigs in 18 months 6 ways to safety-proof your EMS fleet Memorable quotes "It’s no good going to City Council or to your board of directors on day 365 and saying, ‘I need a new truck for New Year day one’ — that’s not going to happen." — Rob Lawrence "The ground vehicle standard has become the standard that most vehicles are being built to and that state EMS officials are using." — Mark Postma "We spend a lot of time thinking about where things go in the box … add one more thing to your checklist: can the vehicle indeed be immobilized?" — Rob Lawrence "There’s just no reason why ambulances are being stolen with the current technology that’s out there." — Mark Postma Episode timeline 00:45 – Rob introduces the topic: GVS 4.0 and ambulance theft concerns 01:34 – Mark introduction and CAAS GVS role 04:11 – How the CAAS standards were developed and adopted by 35-plus states 06:09 – Comparing CAAS GVS to NFPA ambulance standards 06:48 – The rise of remounting, especially during COVID supply shortages 10:26 – Discussion of ongoing vehicle delivery delays and need for replacement planning 15:04 – What’s new in GVS 4.0 — major changes and safety structure updates 19:38 – Ambulance theft statistics and the GVS anti-theft requirement 22:28 – Automatic immobilization and why manual systems fail 23:57 – Mark shares success story: zero thefts since installing devices 26:17 – Exceptions in standards and why state inspectors must enforce anti-theft 27:42 – Final thoughts on making anti-theft part of fleet planning Enjoying the show? Email editor@ems1.com to share feedback and suggest future guests. 

In this edition of the EMS One-Stop podcast, host Rob Lawrence Zooms (literally) from the U.K. to South Carolina to spotlight one of the nation’s most forward-thinking mobile integrated healthcare programs. Prisma Health’s team has taken community paramedicine beyond buzzwords, designing targeted, evidence-based programs that meet people where they are — both geographically and medically. | MORE: How North Dakota EMS is confronting rising pediatric mental health crises  Whether it's addiction medicine, rural HIV/HCV treatment or skilled nursing interventions, this team is shifting paradigms on what EMS can and should be doing. Rob is joined by four key voices from the Prisma Health MIH program: Luke Estes, director of MIH Dr. Mirinda Gormley, epidemiologist and biostatistician Wes Wampler, community paramedic specializing in addiction and infectious disease Parker Bailes, community paramedic and research contributor Together, they unpack how passion meets data to drive change, how to earn trust in communities overlooked by traditional systems, and why this work isn’t just novel — it’s necessary. This is EMS in its truest public health form. Memorable quotes “You delivered the goods—data-driven, community-connected care — and that’s what EMS in 2025 needs more of.” — Rob Lawrence “When you see some of your people who have a passion for a certain pathway in EMS, you try to give them the reins and say, you're gonna do some good.” — Luke Estes “One of the big things that we learned from his study was that we really needed to go out and make sure everybody was aware that addiction is a disease.” — Mirinda Gormley “If we can gain their trust, there’s a lot more that we can kind of weasel our way into to help them solve and get them on a healthier trajectory.” — Wes Wampler “Walking into the (care) facility with the mindset of, ‘I'm going to do everything I can to keep you here,’ was a big shift for me.” — Parker Bailes “If we can set them up to be successful after they leave the hospital, I think that's the best way to get them reengaged with the hospital.” — Wes Wampler “As their leader … all I have to say is, what do you need? I'm here to support you.” — Luke Estes Additional resources EMS Clinician Perceptions on Prehospital Buprenorphine Administration Programs: Prehospital Emergency Care: Vol 29 , No 4 Implementation Barriers of Prehospital Buprenorphine Administration Programs in the United States: A Scoping Review: Prehospital Emergency Care: Vol 29 , No 4 Using Community Paramedicine to Treat Hepatitis C Virus in Upstate South Carolina - PMC Luke Estes BA, NRP, CCEMTP, PNCCT, FP-C, CP-C | LinkedIn Wesley Wampler | LinkedIn Support for harm reduction by community EMS How does a community re-imagine compassion to avoid crisis whenever possible? Breaking barriers: Hennepin EMS leads the way in safely implementing buprenorphine Episode timeline 00:51 ­– Introduction to Prisma Health MIH & guests 03:00 – Luke Estes overview of MIH models (ETS, SDOH, addiction) 05:00 – Dr. Gormley’s public health journey, data-opioid focus 08:00 – Buprenorphine pilot design and research outcomes 10:15 – Challenges: bias, stigma, barriers to addiction care 13:00 – Funding and sustainability conversation 14:00 – Wes Wampler on daily workflow in addiction medicine and HCV care 17:00 – Building trust with vulnerable populations 18:30 – Parker Bailes discusses traditional CP role and skilled nursing interventions 21:45 – Alternative destinations, lab draws and high-acuity decisions 25:30 – Training: internal education, ultrasound, medication management 28:15 – Prisma’s med school connection and disaster response evolution 30:00 – State-level partnerships: SC EMS Assn, FEMA typing, CP strike teams 31:56 – Academic next steps from Dr. Gormley: scaling, publishing, process evals 35:26 – Final reflections from Luke Estes: passion, team strength and mission 38:00 – Rob’s call to action: “If you want your own Prisma team — start now.” Enjoying the show? Email editor@ems1.com to share feedback or suggest future guests. 

In this high-impact edition of the EMS One-Stop podcast, host Rob Lawrence sits down with EMS influencer and educator Jimmy Apple, known widely across platforms as The EMS Avenger. With nearly 70,000 followers on TikTok and a growing presence on Instagram and Facebook, Jimmy has mastered the art of compressing complex clinical topics into digestible, engaging content. | More: What the EMS Counts Act means for dual-role EMS providers  In this conversation, Rob pulls back the curtain on the man behind the mobile screen — exploring Jimmy's journey from electrician to pediatric critical care paramedic, and now, one of EMS's most watched and listened-to voices. Listeners will gain deep insight into Jimmy’s origin story, his social media strategies, his refusal to let bad information go unchallenged, and his passionate belief that “Saving lives begins with kindness.” The pair also tackle: Content creation advice for EMS agencies The challenges of tone and accuracy in short-form video How to maintain compassion in the face of a toxic work culture This episode is part masterclass in communication, part call to action for the future of EMS — and all heart. Memorable quotes from Jimmy Apple: The EMS Avenger “Saving lives begins with kindness. That is my motto, it is my philosophy.” “You have to package something down to its bare essence … there's some nuance lost, but you have seconds to keep people's attention.” “My goals going forward are to support people who are acting in good faith while correcting the misinformation.” “Generally speaking, you will draw the engagement that you're looking for. If you're putting out content in good faith, you'll get good faith engagement.” “We are responsible for ourselves and how we respond … and I believe we need to respond to everything that is happening in the world today with kindness.” Episode timeline 00:54 – Rob introduces Jimmy Apple, aka the EMS Avenger 01:20 – Jimmy’s background: from electrician to EMS 03:30 – The grandfather conversation that changed his life 04:50 – How pathophysiology sparked a love for learning 05:40 – Birth of the EMS Avenger: from student favorite to TikTok influencer 06:55 – Ginger Locke’s advice that redirected Jimmy’s podcast path 08:04 – Compressing content: "from textbook to bumper sticker" 10:00 – The content hook: “Are we getting rid of normal saline?” 11:00 – How Jimmy selects topics: research, news, curiosity and requests 13:00 – Hot topics in EMS: cricothyrotomy, TXA, ketamine, provider safety 14:40 – Rob discusses EMSIntel.org and ambulance theft data 16:00 – Can EMS agencies do what Jimmy does? The risks and the realities 18:30 – "Stop the finger": creating content that captures attention 20:00 – Rob on the risks of public messaging and backlash 21:00 – Calling out misinformation: the line between education and shame 23:00 – Jimmy’s growing reach across TikTok, Instagram and Facebook 24:45 – Managing Facebook’s deeper comments and nuanced conversations 26:45 – Jimmy’s rule: “Engage only with good faith” 27:50 – Final thought: EMS must rediscover kindness 29:00 – Closing remarks and where to follow Jimmy Apple online Additional resources Connect with Jimmy Apple, better known as The EMS Avenger: TikTok — Jimmy offers short-form, evidence-based EMS content here: @emsavenger Instagram — Engage with in-depth reels, visuals, and professional updates: @emsavenger X (formerly Twitter) — Follow EMS commentary, conversation, and boosts: @EMSAvenger Facebook — Join the group for discussions and shared insights: EMS Avenger community Apple Podcasts — Listen to “EMS Avenger: 20 Minutes to Save the World”: Weekly podcast series AAA & AIMHI EMS Media Log: EMS Intel Enjoying the show? Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback.

In this special crossover edition of EMS One-Stop and The Bridge Podcast from the Kentucky Office of Rural Health, host Amelia Holliday leads the conversation, joined by Scott Helle, rural project manager at KORH; and Rob Lawrence, host of EMS One-Stop and EMS leader. Recorded live at the 2025 Kentucky EMS Leadership Academy, this episode explores the evolution, design and impact of the Leadership Academy on Kentucky’s rural EMS landscape. The discussion dives into the Academy’s origins, structure, statewide reach and its mission to prepare the next generation of EMS leaders in some of the most resource-challenged communities in the country. From the realities of low-volume, underfunded rural services, to the inspiring stories of leadership growth and resilience, this episode offers a thoughtful examination of the challenges facing EMS in Kentucky and beyond. Rob reflects on leadership principles drawn from his military and EMS career, while Scott provides a blueprint for how to build and sustain EMS talent in small communities. Together with Amelia’s thoughtful moderation, this episode highlights how mentorship, structured learning and network-building are transforming rural EMS leadership — one cohort at a time. Additional resources The Bridge Podcast (Contains additional discussion) Center of Excellence in Rural Health: Established to address health disparities in rural Kentucky Asking the big questions: Industry leaders weigh in on celebrating EMS Week amidst the forces shaping the EMS landscape Cultivating the next generation of EMS: Leadership development, emotional intelligence and the importance of mentorship Memorable quotes “We’re promoting people above their level of competency — not because they’re not good, but because we haven’t prepared them for what’s next.” — Rob Lawrence “We saw early on that EMS professionals were great at clinical care, but we were missing the leadership piece.” — Scott Helle “Effective communication is the core of good leadership. You can’t lead without it.” — Amelia Holliday “My six principles: pride, integrity, learning, humor, service and courage. They guide everything I do.” — Rob Lawrence “It costs money to build people. That’s why we provide this Academy at no cost to participants.” — Scott Helle “It’s hard to run EMS in a state where many counties don’t even have a tax base to support it.” — Scott Helle “You’re always leading. Once you start, it never stops. People are always watching and listening.” — Rob Lawrence “We’re not just building leaders — we’re building mentors, networks and future change-makers.” — Scott Helle “Nobody becomes a good leader because they want power. The best leaders are those who understand the responsibility.” — Amelia Holliday Episode timeline 00:18 – Introduction to the Kentucky Leadership Academy and crossover with The Bridge Podcast 02:29 – How the Academy was formed and why it was needed 05:00 – Structure of the Academy, application process and regional representation 08:11 – EMS 2050, developing next-gen leaders, and avoiding the Peter Principle 11:00 – The importance of non-clinical leadership education 13:36 – Funding challenges in rural EMS, tax base realities and sustainable operations 17:41 – Rural EMS dynamics, local politics and the true cost of readiness 21:25 – Hospital closures and extended transport times — national rural EMS challenges 24:11 – Leadership is constant: visible, energetic and principle-driven 28:14 – Rob’s military leadership values and the weight of being observed 32:35 – Leadership as service and the power of building trust within teams 34:58 – Rob’s group dynamics “icebreaker” exercise and lessons on leadership styles 39:33 – Mentorship benefits both ways: mentees gain confidence, mentors renew purpose 44:49 – Academy success stories and graduates becoming leaders elsewhere in EMS 46:44 – Closing comments and podcast wrap-up with Amelia and Rob Rate and review the EMS One-Stop podcast Enjoying the show? Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback.

In this episode of the EMS One-Stop podcast, host Rob Lawrence sits down with Danielle Thomas, chief operating officer, Lifeline EMS of Los Angeles, to explore how her team is harnessing “actual intelligence” — through a proprietary, closed-source AI platform called InCheck — to solve a perennial EMS headache: information overload. Thomas explains how embedding agency-specific protocols, an 800-page policy manual and multi-language translation into a single voice-activated app gives every crew member a “mentor in their pocket,” shrinking cognitive load, sharpening clinical decision-making and smoothing onboarding during the critical first 80 hours of employment. | More: From 73 to 33 minutes: How Sacramento reinvented patient offload times  The conversation ranges from her move from Boston to California and the regulatory culture shock that followed, to Lifeline’s recent CAAS accreditation push and the wider potential of AI-driven tools to boost recruitment, retention, compliance and patient safety. In the second half, Rob and Danielle expanded the conversation from tools to leadership strategy, focusing on how EMS agencies can better support staff in high-pressure, multi-jurisdictional environments. Thomas shares how her team tackled issues like protocol confusion, inconsistent policy knowledge and language barriers — not by adding more training sessions, but by rethinking how information is delivered, accessed and retained on the front lines. She emphasizes the importance of aligning education with the way today’s workforce learns, communicates and engages — especially during the critical first days of employment. The episode closes with a preview of Danielle’s upcoming AAA conference presentation with Carly Strong, which challenges perceptions of gender in EMS leadership and spotlights the untapped potential of inclusive, thoughtful organizational development. Memorable quotes “If you can, as the leader in an EMS organization, figure out how to enhance not only that first 80 hours, but that team member experience.” — Danielle Thomas “As everybody listening knows, I'm sure that every new policy probably has somebody's secret name attached to it because of what happened.” — Rob Lawrence “It honestly solves our recruitment and retention issues because they want to come to work.” — Danielle Thomas “I happen to believe that [AI is] an on-the-train or under at the moment kind of thing … we now have to move forward. It's part of our life. We have to embrace it and we have to employ it.” — Rob Lawrence “The left coast is more highly regulated and so I was not used to the labor laws in California and I was not used to the way that the local EMS authorities work.” — Danielle Thomas “I think every company I've worked at that that was a thing and so we had to create a solution to the problem we had, which was information overload.” — Danielle Thomas Episode timeline 01:25 – Welcome to Danielle Thomas 02:56 – East-to-West move and California’s regulatory maze 4:12 – Lifeline EMS footprint across Los Angeles, Orange and Riverside Counties 6:27 – The policy-overload dilemma in multi-county operations 10:01 – InCheck: turning 800 pages into actionable intel 14:53 – From AI skeptic to evangelist — programming county-specific protocols 18:30 – Five operating modes explained (Rampart, Angel, Nova, L-Chat Narrative) 28:00 – 100-language instant translation with Nova 34:51 – Building the tool in-house; cost and compliance advantages 38:43 – Preview of AAA Conference session, “Just one of the guys” 41:33 – Final takeaways: enhancing the first 80 hours and keeping crews engaged 42:44 – Closing remarks Rate and review the EMS One-Stop podcast Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback. Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.

In this international edition of the EMS One-Stop podcast, host Rob Lawrence welcomes Lewis Andrews, the chief operating officer of the United Kingdom’s College of Paramedics, for an insightful discussion on two major topics shaping global paramedicine. First up is International Paramedic Day, taking place on July 8, 2025. Now in its third year, the day honors the contribution of paramedics across the world and draws its inspiration from the birthday of Dominique-Jean Larrey, the father of battlefield ambulance care. Lewis explains how the day has grown from 50 initial partners to over 150 global organizations, with this year’s theme being “Unity and community.” The day aims to raise awareness of the profession, share innovations and bring together the global paramedic community. MORE | How community paramedicine is thriving in the UK: Dr. Linda Dykes and Rom Duckworth discuss trans-Atlantic lessons in emergency management In the second half of the show, Lewis delves into the structure and significance of the College of Paramedics, which represents nearly half of the UK’s registered paramedics. He describes how the UK paramedic profession is regulated and protected by law, with a rigorous educational pathway that now includes the potential for prescribing paramedics and direct-to-primary-care tracks. Rob and Lewis explore how paramedics in the UK are increasingly working beyond emergency ambulances — in GP surgeries, urgent care centers and academic roles. Their conversation offers a rich comparison point for U.S. EMS leaders seeking to elevate paramedicine through autonomy, education and broader clinical roles. Memorable quotes “This is not a commercial platform — this is about us celebrating us.” — Lewis Andrews, on the ethos of International Paramedic Day “Let’s not reinvent the wheel, but let’s look at what the wheel is for the environment that it’s required to roll in.” — Lewis Andrews, on global EMS collaboration “The title ‘paramedic’ is protected by law in the UK — you can’t simply do a first aid course and call yourself one.” — Rob Lawrence “Autonomy — in a word — that’s what makes a prescribing paramedic.” — Lewis Andrews, on expanding paramedic roles “We’re also promoting the profession to those who don’t yet know they want to be in the profession.” — Lewis Andrews, on recruitment and professional identity “We have a career framework … that actually shows that you can develop from that day one newly qualified right through to a consultant paramedic, chief paramedic, director, professor.” — Lewis Andrews Episode timeline 00:55 – Introduction to International Paramedic Day (IPD) and its origins 02:17 – Why July 8 was chosen: Dominique-Jean Larrey’s birthday 03:02 – Growth of IPD from 50 to over 150 partners 05:06 – 2025 theme: “Unity and community” and sub-objectives 06:45 – How to participate: share stories, use hashtags (#UnityAndCommunity and #IPD2025), connect globally 08:58 – The global nature of IPD and U.S. partners’ involvement 11:25 – Promoting awareness and the importance of celebrating paramedics 12:50 – Part 2 — The role of the College of Paramedics 14:09 – Overview of College functions: CPD, representation, research, advocacy 18:15 – Registration with HCPC, protected title and the regulator’s role 21:12 – Paramedic education in the UK: degree pathways, demand and cost 23:46 – Discussion on streaming directly into primary care roles 27:09 – Career framework: from graduate paramedic to chief paramedic/professor 30:16 – Prescribing paramedics: autonomy and improved patient experience 33:08 – Recap and call to action: visit www.internationalparamedicsday.com 34:17 – Like, subscribe and engage ADDITIONAL RESOURCES International Paramedics Day Resources UK College of Paramedics The standards of proficiency for paramedics RATE & REVIEW Enjoying the show? Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback.

In this vital episode of EMS One-Stop, host Rob Lawrence is joined by Matt Zavadsky and attorney Doug Wolfberg of Page, Wolfberg & Wirth for a deep-dive into three financial flashpoints currently impacting EMS. First, the trio unpack the launch of the new PWW|AG/EMS|MC EMS Financial Index, a quarterly report leveraging billing and revenue cycle data from over 1,500 agencies nationwide. This unprecedented benchmarking tool allows EMS leaders to measure performance against regional and national trends, uncovering actionable insights into billing strategies, reimbursement rates, payer mixes and the economics of service delivery. It’s a critical step in helping agencies justify their value and improve their financial sustainability. Next, the discussion turns to MedPAC — the Medicare Payment Advisory Commission — and its controversial response to cost data submitted by ambulance services under the CMS Ground Ambulance Data Collection System. Doug Wolfberg explains how MedPAC discarded over half of the data, labeling higher-cost services — often rural or government-run — as outliers. This move could justify lower or stagnant Medicare fee increases, potentially devastating many providers. Finally, attention shifts to the “One Big Beautiful Bill” moving through Congress and now on its way to the Senate that would eliminate or severely restrict enhanced Medicaid funding mechanisms, such as supplemental payments and provider taxes. If passed, this legislation would reduce reimbursement for millions of transports, triggering funding crises across EMS systems — particularly in states like California and Illinois. The episode delivers a clear message: EMS leaders must prepare, advocate and act now. Episode timeline 00:41 – Rob introduces the three main topics: the PWW|AG/EMS|MC EMS Financial Index, MedPAC’s response to ambulance data and a major federal bill impacting Medicaid 01:59 – Part 1 — PWW|AG/EMS|MC Financial Index 03:37 – Matt explains that the index is built using data from over 1,500 EMS agencies via EMS|MC 05:43 – The importance of regional benchmarking 08:22 – First major finding: dramatic variation in ALS billing rates across regions 09:30 – Key insight: agencies that bill more tend to collect more revenue — agencies are encouraged to determine their true cost of service and align billing accordingly 12:37 – Collection percentage is debunked as a misleading metric; focus should be on dollars collected 15:36 – ALS vs. BLS billing levels explained, with a look ahead to Q2’s emergency-only data set 18:48 – How EMS agencies can better engage with insurers to cover non-transport and MIH services 20:46 – Part 2 — MedPAC 22:24 – Doug outlines how MedPAC discarded over half of the reported ambulance cost data 25:00 – Explanation of which data was discarded and why — primarily high-cost, rural and government-based services 28:22 – Doug asserts MedPAC is using cherry-picked data to suppress reimbursement increases 30:10 – Rob and Doug emphasize that EMS gave MedPAC quality input, but MedPAC is producing garbage output 32:08 – Doug outlines what MedPAC will do next and what EMS leaders must do in response 34:40 – Strong call to action: educate Congress, use real CMS data and don’t accept MedPAC’s narrative 36:59 – Doug emphasizes the importance of evidence-based deployment strategies for financial sustainability 37:31 – Part 3 — “One Big Beautiful Bill” 38:19 – Matt outlines how the bill would drastically limit Medicaid supplemental payments 39:43 – Federal/state Medicaid match rates explained with California as an example 42:51 – The looming reckoning: local governments may have to pay to maintain current EMS service levels 46:02 – Matt warns that the bill could trigger PAYGO cuts to Medicare as well 47:16 – Agencies are urged to plan now, talk to their communities and adjust operations 48:06 – Doug adds that pressure on U.S. senators, especially in red states, could still influence the bill 51:26 – Close and call to action Final takeaway This episode underscores that EMS cannot remain reactive — leaders must proactively use data, engage legislators and educate their communities on the true cost of care. The EMS Financial Index, the MedPAC dismissal, and the pending bill all point to a critical need for informed, strategic advocacy.

In this episode of the EMS One-Stop podcast, host Rob Lawrence sits down with returning guest Chief Robbie MacCue of Colonie EMS (New York) to explore the transformative potential of the Safe Streets and Roads for All (SS4A) federal grant program. Funded by the Infrastructure Investment and Jobs Act, SS4A aims to prevent roadway fatalities and enhance post-crash care. With $5 billion available nationwide and $900 million still on the table for FY25, this conversation is a call to action for EMS agencies across the country. Chief MacCue shares the story of how his department, in collaboration with neighboring EMS and police agencies, secured $2.4 million in SS4A funding for a project focused on innovative vehicle alert systems, prehospital health information exchange and groundwork for whole blood deployment. From demystifying the grant application to defining success metrics and compliance reporting, this episode breaks it all down — turning policy into practice, and complexity into impact. Memorable quotes “I was pretty taken back by the statistic that 40% of these patients were alive when EMS arrived and later died. Those are patients that are talking to us that are no longer living after a crash.” — Robbie MacCue “This isn’t free money. It comes with reporting requirements, match funding and responsibility — but there’s help out there, and it’s absolutely worth it.” — Robbie MacCue “Our goal is to go upstream to the source of the problem. How do we stop the bleeding? How do we stop some of these accidents from actually happening?” — Robbie MacCue “We put a two-page narrative together that generated a $3,000,000 regional application … based on simple principles about statistics.” — Robbie MacCue “Post-crash care is definitely a missing element in the Safe System Approach … and EMS needs to be part of the solution, not just the response.” — Robbie MacCue “You don’t have to have all the solutions right away. You just have to have the initiative to get with other like-minded people.” — Robbie MacCue “This project isn’t just for crashes. It will also help us with high-utilizer patients and improve reimbursement accuracy by connecting data silos.” — Robbie MacCue “Somebody emailed me in the week to say that the EMS One-Stop podcast is the podcast that’s able to turn a very complex EMS topic into a car bumper sticker. So there you go. If we’re doing that and we can achieve that, then we’re getting somewhere.” — Rob Lawrence Episode timeline 00:00-02:00 – Intro to SS4A and the scale of available funding ($5B) 02:00-04:00 – Why post-crash care matters: 42% of patients alive at EMS arrival die later 04:00-07:00 – How Colonie EMS discovered and approached the SS4A opportunity 07:00-10:00 – Building a regional grant application and tripling the funding 10:00-13:30 – Overview of the proposed project – transponder tech, health information exchange and whole blood 13:30-17:00 – Specific technology being explored and integration challenges 17:00-20:00 – Working with MPOs, consultants and navigating acronyms 20:00-25:00 – Finding the 20% match, leveraging in-kind contributions and funding timelines 25:00-30:00 – Federal reporting requirements and budgeting with SF-424A 30:00-35:00 – The big goal: Closing the outcome data loop and EMS-hospital data sharing 35:00-40:00 – Measuring success, from whole blood to vehicle alerts 40:00-42:30 – Robbie’s final advice: “Don’t be intimidated — reach out and apply.” ADDITIONAL RESOURCES SS4A Application Portal & Resources: Safe Streets and Roads for All (SS4A) Grant Program | US Department of Transportation NHTSA’s Office of Emergency Medical Services | EMS.gov Lexipol Grants Support Metropolitan Planning Organizations (MPOs) database

In this episode of the EMS One-Stop podcast, host Rob Lawrence kicks off a special series spotlighting national EMS associations, beginning with a deep dive into the EMS Personnel Licensure Interstate CompAct (REPLICA). His guest, Donnie Woodyard Jr., executive director, Interstate Commission for EMS Personnel Practice, brings decades of EMS experience and leadership to the table to demystify what the EMS Compact is, how it operates, and why it matters to the profession today. From improving workforce mobility to protecting public safety during disasters, Woodyard Jr. provides clarity on this critical multi-state agreement. The conversation covers everything from how EMS Compact came to be, to the significance of national registry standards, disaster response logistics, interstate licensure, and even leadership lessons from Woodyard Jr.’s latest book project, “Leadership in action: The Wisdom and stories of EMS innovators”. Whether you're a field provider or policymaker, this episode is a must-listen for understanding how collaborative legislation can shape the future of EMS. In the episode, Woodyard Jr. candidly addresses the ongoing debate in North Carolina over transitioning from a state-only EMS certification exam to exclusive use of the National Registry. Woodyard Jr., while respectful of North Carolina’s long-standing EMS tradition, emphasizes the importance of national consistency. He acknowledged that the proposed legislation needed amendments, particularly around grandfathering existing providers, but stood firm in his belief that a single, legally defensible national standard is essential for provider mobility and professional integrity. Drawing on real-world examples, Woodyard Jr. described how providers are often caught off guard when relocating — only to discover their credentials aren't accepted elsewhere. “Maintaining a state-only exam is harmful to individuals,” he said, calling for unified testing standards that support workforce movement and strengthens the profession nationwide. Memorable quotes from Donnie Woodyard Jr “Every EMT and paramedic in the United States should go through a fingerprint background check. You know, babysitters have to do it. Teachers have to do it. EMS personnel absolutely should do it.” “Maintaining a state-only exam is harmful to individuals. It limits their mobility.” “When you waive that requirement for licensure, you actually are removing essential elements of public protection and accountability.” Timeline 00:21 – Rob introduces the series on national EMS associations and welcomes Donnie Woodyard, Jr. 01:55 – Woodyard, Jr.shares his EMS journey from volunteer in Virginia to international disaster medicine and state leadership 03:41 – What is the EMS Compact and how does it work? 06:38 – Challenges of multistate EMS licensing pre-Compact 08:00 – Explaining the driver’s license analogy and compact accountability 11:17 – EMAC vs. EMS Compact for disaster response and liability concerns 15:31 – National Registry and grandfathering provisions 17:30 – Arkansas joins as the 25th compact state 18:56 – Model legislation and how states join the compact 21:22 – What REPLICA stands for and its legislative origin 22:20 – What California (and other non-compact states) should consider 24:33 – National Registry debate: North Carolina’s challenges and Woodyard, Jr.’s response 27:52 – Mobility, workforce attrition and job-sharing innovation 30:11 – The Commission and national EMS-coordinated database 35:17 – Final thoughts on fragmentation, collaboration and EMS unity 36:41 – Woodyard, Jr.’s leadership book, EMS charity support and Secretary Panetta’s forward 41:08 – Closing remarks and contact information Additional resources Learn more about the EMS Compact “Leadership in action: The Wisdom and stories of EMS innovators”, by Donnie Woodyard Jr. “The future of emergency medical services: Artificial intelligence, technology & innovation”, by Donnie Woodyard Jr.

In this special data-driven edition of the EMS One-Stop podcast, host Rob Lawrence is joined by Dr. Brent Myers, chief medical officer, ESO, and Dr. Remle Crowe, ESO’s director of clinical and operational research, to unpack the newly released 2025 ESO EMS Index. This annual report provides a powerful, real-world snapshot of national EMS trends — drawing on more than 14 million anonymized records to surface opportunities for clinical and operational improvement. The conversation dives into key metrics that move beyond response times and into areas like pain management, opioid overdoses, airway confirmation, obstetric emergencies, whole blood use, pediatric behavioral health and high-utilization patient populations. Throughout the episode, Drs. Myers and Crowe share the motivation behind each metric, explain how the data was gathered and analyzed, and reflect on how EMS agencies can use these insights to guide better care delivery and system design. From confronting equity in pain management, to pushing forward innovations like buprenorphine administration and whole blood programs, this is a compelling call to turn data into meaningful change. Timeline 01:08 – Overview of the ESO EMS Index and its intent 02:59 – Origins of the report and data methodology 05:46 – Database scale: 14M+ records, 3,000+ agencies 07:14 – Metric 1: Pain management for long bone fractures 10:53 – Documentation, AI in EMS, and future documentation tools 14:30 – Metric 2: Suspected opioid overdose and buprenorphine use 18:51 – Best practices, COWS scoring, and naloxone delivery strategy 21:31 – Metric 3: Invasive airway confirmation using waveform capnography 28:06 – Metric 4: Obstetric emergencies (postpartum hemorrhage & hypertension) 34:34 – Metric 5: Prehospital whole blood surveillance 40:22 – Metric 6: Pediatric behavioral health and substance use disorder cases 44:54 – Metric 7: High utilization patient group (HUG) 52:48 – Final thoughts, calls to action, and Rob’s reflections 55:47 – Episode wrap-up and subscription reminder

In this episode of EMS One-Stop, host Rob Lawrence is joined by Dr. Christine Carico and Dr. Matt Levy to discuss the peer-reviewed paper, “Nationwide Trends in Prehospital Blood Product Use After Injury.” The paper, published in “Transfusion” in April 2025, explores the use of blood products in prehospital trauma care. Despite the proven benefits of blood transfusion in the field, their research uncovers the alarming reality that less than 1% of eligible patients receive prehospital blood products. This conversation dives into the study’s methodology, key findings and the significant barriers EMS systems face in implementing blood transfusion protocols. The discussion also touches on the evolving role of EMS in trauma care, regional variations in blood product access, and the future of prehospital blood transfusion programs. Dr. Carico and Dr. Levy break down their work and reflect on the data, explaining how the study used National Emergency Medical Services Information System (NEMSIS) data to identify trauma patients who would have benefited from blood transfusions. The episode delves into the operational challenges EMS systems face in obtaining and administering blood products in the field, the financial and logistical obstacles, and the potential life-saving impact of more widespread adoption of these protocols. Timeline 00:00 – Intro and welcome: Rob Lawrence introduces Dr. Matt Levy and Dr. Christine Carico, setting up the discussion on prehospital blood product use 03:00 – Study overview: Dr. Carico explains the methodology of the study, focusing on the use of NEMSIS data and the inclusion criteria for the patient population 07:00 – Key findings: Dr. Carico reveals the key findings of the paper, including the low percentage of eligible patients receiving prehospital blood products 11:00 – Barriers to implementation: Dr. Levy discusses the main barriers to the widespread implementation of blood transfusion protocols in the field, including access to blood, logistics and training 17:00 – Regional variations: The speakers touch on the regional disparities in blood product availability and the differences in protocols across the country 23:00 – Data challenges: Dr. Levy and Dr. Carico discuss the challenges related to data accuracy, particularly in terms of blood product documentation 27:00 – Cost and reimbursement: Dr. Levy addresses the financial aspects of blood product programs, including cost, reimbursement challenges and funding opportunities 32:00 – The future of blood transfusion in EMS: Dr. Levy envisions the future of prehospital blood transfusion programs, including the potential for shelf-stable blood products and regional blood supply systems 37:00 – Closing thoughts: Both guests offer their final thoughts on the importance of continued research and data collection, and the need for EMS to embrace a more integrated role in acute care Additional whole blood resources Carico C, Annesi C, Clay Mann N, Levy MJ, et al. “Nationwide trends in prehospital blood product use after injury,” 2025. Transfusion – Wiley Online Library Tracking the whole blood landscape as updated guidelines allow EMS to carry and administer whole blood EMS One-Stop: Stop the bleed, fill the tank – The New Orleans EMS blood program Insider analysis: Delaware’s statewide whole blood rollout sets a new EMS standard Whole blood in EMS promises a revolution in resuscitation: How one county agency is saving lives with prehospital transfusions Matthew Levy | LinkedIn Christine Carico | LinkedIn

In this episode of the EMS One-Stop podcast, host Rob Lawrence is joined by Deputy Director Tracey Loscar from Mat-Su Borough EMS in Alaska. Together, they discuss the looming threat of Mount Spurr, a volcano located 75 miles west of Anchorage, which is currently showing signs of potential eruption. Loscar provides insights into disaster management and preparedness in a region where EMS operations are stretched across vast, remote territories. The conversation also touches on how to plan for the unexpected, especially in an environment with limited resources and harsh geographical challenges. This episode delves into the logistical challenges faced by EMS in the face of volcanic activity and offers critical lessons in disaster management. TIMELINE 00:22 – Rob Lawrence welcomes Deputy Director Tracey Loscar and sets the stage for a discussion on disaster management in Alaska 02:10 – Loscar gives a brief overview of Mat-Su Borough and its proximity to Mount Spurr 04:01 –Loscar discusses her transition from Newark, New Jersey, to Mat-Su Borough and the challenges of EMS in rural Alaska 06:00 – Lawrence and Loscar discuss the vast distances and limited resources available in the region 08:01 – Loscar explains the preparations for the potential ash fallout from Mount Spur, including messaging to the community and respiratory protection 10:04 – The conversation shifts to the nature of volcanic ash and the practical challenges it presents to infrastructure, vehicles and personal health 14:36 – Loscar shares lessons learned from previous seismic events, such as the 2018 earthquake, and emphasizes the importance of clear communication during disasters 17:06 – Lawrence and Loscar discuss EMS liaison roles and the need for better coordination between dispatch, EDs and field teams 18:01 – Loscar talks about the current status of the Mount Spur eruption, with no immediate risk but preparations ongoing, and discusses how Alaskans stay calm and prepared in the face of frequent natural events, from earthquakes to volcanic eruptions 20:03 – Loscar highlights the importance of including pets in emergency plans, emphasizing the need for respiratory protection for animals 21:00 – The role of pantyhose in volcano preparedness RATE AND REVIEW Enjoying the show? Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback.

In this episode of EMS One-Stop, recorded live from the ABC 360 and XI Conference, host Rob Lawrence chats with keynote speaker Catherine Kuhlmann, a firefighter-paramedic with over 26 years of experience.   Kuhlmann discusses the importance of understanding both internal and external customer service in EMS, emphasizing the need for a healthy organizational culture to ensure the best patient care. She reflects on the profound impact that first responders can have on individuals, drawing from her own experiences and personal tragedies to highlight the emotional resilience required in the profession.   Rob also speaks with Page Wolfberg & Wirth’s PWW/AG Principal Doug Wolfberg, long-time EMS lawyer and educator, about lessons learned from working in and around law enforcement during patient care. Wolfberg provides actionable insights into how EMS professionals can better collaborate with police officers, ensuring that patient care remains a priority while navigating complex, high-stress situations. Together, Kuhlmann and Wolfberg offer invaluable perspectives on fostering better patient advocacy, maintaining professional integrity and refining EMS protocols to adapt to new challenges. MEMORABLE QUOTES “How many careers, professions are there that, more often than not, you can make somebody's worst day their best?" — Catherine Kuhlmann "If you want to know what's going on in your hospital, ask housekeeping. Patients will not remember that you worked your butt off for 45 minutes to restart their heart … but they will remember that you tucked their feet in with a blanket underneath it." — Catherine Kuhlmann "You have to have a healthy department in order to continue to be healthy. And a lot of times when people think that they have problems with an individual and their agency, sometimes it’s not actually a problem with the individual, it’s with the agency." — Catherine Kuhlmann "We have a duty to the patient. We're not there to help the police. We're there to advocate and treat the patient." — Doug Wolfberg "EMS cannot subordinate judgement to law enforcement. If a police officer says give this guy some juice and put him to sleep, we first have to do an assessment and figure out if clinically that's the right thing." — Doug Wolfberg ADDITIONAL RESOURCES ABC 360 and XI Conference is Page Wolfberg & Wirth Advisory Group’s all-day workshop for EMS leaders, chiefs, HR managers and compliance professionals. Vodcast: Lessons from the McClain case: Protecting first responders and improving EMS practices Balancing care and collaboration: Key lessons from EMS and law enforcement interactions TIMELINE 00:37 – Catherine Kuhlmann introduces herself, detailing her extensive background in EMS, law enforcement, and as a justice of the peace. Rob then highlights the key themes of Kuhlmann’s keynote speech, which revolves around the importance of understanding the "why" in EMS. 02:16 – Kuhlmann discusses the importance of organizational culture in retaining quality personnel and how many individuals leave — not due to the work itself — but because of the agency's culture. Kuhlmann talks about the personal fulfillment that comes from EMS work, sharing a story about a young girl she saved who later became a doctor. 06:13 – Kuhlmann introduces the concept of "Murphy," a problematic employee in the agency, and suggests that sometimes these individuals may reflect a deeper organizational issue. 08:12 – Kuhlmann emphasizes the importance of communication, advising that EMS leaders should hold honest, one-on-one conversations with problematic staff before resorting to exit interviews. 12:04 – Kuhlmann reflects on the small gestures that have a lasting impact on patients, highlighting how seemingly minor acts of compassion can leave a lasting impression. 14:03 – Rob and Kuhlmann discuss the concept of bedside manner in EMS, stressing the importance of treating patients with dignity and respect. Kuhlmann closes with a powerful message about EMS professionals’ responsibility to treat others’ families with the same care and respect as they would their own. 21:06 – Rob Lawrence introduces Doug Wolfberg, who returns to discuss lessons on collaborating with law enforcement in EMS. 22:05 – Wolfberg explains the need for scenario-based training in chaotic environments to build muscle memory and advocate for patients. 23:11 – Wolfberg discusses the importance of EMS maintaining independent clinical judgment, even when law enforcement may request specific actions. 24:03 – Wolfberg stresses the need for clarity in determining whether a patient is in custody and how this affects EMS protocols. 25:06 – Wolfberg explains the importance of advocacy in EMS, particularly in law enforcement scenarios, and the significance of body camera footage for ensuring accountability. 27:13 – Wolfberg shares the potential consequences for EMS professionals who fail to act empathetically or professionally, especially when caught on body camera. 29:15 – Wolfberg speaks about the future of ABC 360, including their upcoming conferences and certifications. Previously on EMS One-Stop

NOTE: Be sure to check out the Inside EMS podcast this month where Rob Lawrence will be joining Kelly Grayson as a guest cohost for Chris Cebollero.  In this episode of the EMS One-Stop podcast, Dr. Dave Williams discusses an exciting new master's-level course designed for EMS and fire leaders, focused on advanced improvement science. Along with Mike Taigman, Dr. Williams is leading this program, which aims to equip leaders with the tools and methods necessary to achieve results-driven improvement in their EMS systems. Over the course of 12 months, attendees will work on real-world projects, gaining the skills needed to make data-driven decisions and improve patient care outcomes within their organizations. Dr. Williams also dives into the core concepts of improvement science, including understanding of variation and the importance of creating organizational systems that support sustainable improvements. He shares insights into the curriculum, the significance of benchmarking and how the course will help EMS leaders tackle systemic challenges by applying proven improvement methodologies. This conversation also touches on the future of EMS leadership and how innovation in data management, process design and leadership will shape the profession moving forward. Timeline 02:22 – Dr. Williams explains the background of the course, highlighting how it builds on improvement science to drive better results in EMS systems. He and Mike Taigman aim to teach EMS leaders to use data and evidence to improve patient care outcomes. 06:16 – Quality improvement: Dr. Williams discusses the gap in EMS leadership regarding quality improvement, emphasizing that quality needs to be integrated into the leadership team’s responsibilities, not treated as a separate function. 11:01 – Why data matters: The conversation shifts to the importance of data in EMS improvement efforts. Dr. Williams highlights how collecting and analyzing data helps organizations understand system performance and drive change. 15:43 – The fleet management example: Rob shares a fleet management story where data was used to improve vehicle downtime, highlighting the real-world impact of using improvement science to solve practical challenges. 19:29 – Project-based learning in the course: Dr. Williams elaborates on the project-based nature of the course, explaining how each participant will bring a real-world project that directly impacts their organization and use improvement science to solve it. 23:09 – Practical applications: Dr. Williams talks about how the course will blend online learning with in-person workshops, providing practical tools and methods that participants can apply to their projects throughout the year. 31:08 – Course logistics: Dr. Williams discusses course deadlines and important dates, including the application deadline of April 18, 2025; and the course's first workshop in September 2025. 54:05 – ROI and the course's value: Dr. Williams emphasizes the return on investment for attending the course, explaining that solving organizational problems through improvement science will ultimately save money and improve results for EMS services. 1:00 – Final thoughts: Rob and Dr. Williams close the conversation by reiterating the uniqueness of the course and its potential to reshape EMS leadership through the application of improvement science. ADDITIONAL RESOURCES Next-level improvement science: New master-level course equips EMS and fire leaders with advanced improvement science skills Course application deadline: April 18, 2025 Course start date: July 22, 2025 Workshop dates: September 2025; February 2026 Mastering data and EMS performance metrics with Mike Taigman: Exploring how data informs change, improves clinical outcomes and drives leadership decisions Improve EMS quality with a model that works: The simple yet powerful Model for Improvement holds the key to making real changes to an EMS organization